All about AIDS Infection 2015 – Dr Diab

AIDS Infection

AIDS or acquired immunodeficiency syndrome is a stage of HIV infection characterized by decreased CD4 count (lymphocytes – immune cells).

Causing agent – RNA-virus of the family Retroviridae – HIV 1 or HIV 2

Epidemiology. Infection is passed from a carrier or HIV sick person.

Means of contamination: direct contact via blood, lymph or plasma or indirect contact through sex “blood from micro wounds, semen, vaginal secretions”, from wound exudates and less commonly from breast milk or saliva.

Clinical classification:

1. 1. Incubation period 2-6 weeks.
   2. The stage or period of primary symptoms

• Phase of acute fever (very identical in clinical symptoms to “infectious mononucleosis – инфекционный мононуклеоз”, in the type of thrombocytopenic purpura, meningitis and meningoencephalitis);
• The silent phase (without symptoms) – from 4 to 12 years
• Persisting generalized lymphoadenopathy.

3. The stage of secondary symptoms:

• Weight loss less than 10%, bacterial, viral and microbe external infections of the skin and genitals, Listeriosis, secondary oropharyngitis, sinusitis;
• Progressive weight loss (more than 10%), diarrhea (diarrhea lasting > 1 mo), fever for more than one month, Hairy leukoplakia, oral, Bacillary angiomatosis , pneumonic tuberculosis, secondary or persistent infections (bacterial, viral, protozoid or microbe) of the internal organs (without dissemination) or deep skin or genital infections, Listeriosis, Candidiasis (oropharyngeal (thrush), vulvovaginal; persistent, frequent, or poorly responsive to therapy), Cervical dysplasia (moderate or severe)/cervical carcinoma in situ, Idiopathic thrombocytopenic purpura, localized Kaposi’s sarcoma, Herpes zoster (shingles), involving at least 2 distinct episodes or more than one dermatome;
• Generalized diseases (bacterial, microbe, viral, protozoid and parasite infection), pneumocytic pneumonia, Candidiasis of the esophagus, bronchi, trachea, or lungs, extrapulmonary tuberculosis outside of the lungs, Coccidioidomycosis, disseminated or extrapulmonary, Cryptococcosis, extrapulmonary, Cytomegalovirus disease (retinitis with loss of vision) , Histoplasmosis, disseminated or extrapulmonary , Lymphoma, Burkitt’s (or equivalent term), Progressive multifocal leukoencephalopathy, Salmonella septicemia, recurrent, Toxoplasmosis of brain, Kaposi’s sarcoma.

4. Terminal stage

Diagnostic Lab tests:

1^st step – Primary screening detection of antibodies to HIV, Detection of HIV RNA in blood provides a sensitive and specific diagnosis of HIV infection even in early stages of the infection.

2^nd step – ELISA by detecting antibody to HIV proteins (if ELISA is reactive then the test is repeated, If it is positive a second time, the Western blot a more specific test should be performed, that is an immunoelectrophoretic procedure for identifying antibodies to specific viral proteins separated by their molecular weight –glycolic lipids гликолепидам 41,120,160 and others)

Reverse-transcription polymerase chain reaction (RT-PCR).

Treatment:

World health organization and most experts recommend that patients at any stage of HIV infection with more than 5000 HIV RNA copies/mL of plasma be treated with a combination therapy example: two nucleosides (eg, ZDV and 3TC), two nucleosides and a protease inhibitor (eg, Ritonavir or indinavir), or two nucleosides and a non nucleoside reverse transcriptase inhibitor (eg, Efavirenz or nevaripine).

1. Ethiotropic treatment: two groups of antiretroviral drugs:

•  a) Inhibiting HIV reverse transcriptase, this group includes medicaments such as nucleosides (eg, Zidovudine {ZDV} 300 mg bid and lamivudine {3TC} 150 mg bid) or non-nucleoside reverse transcriptase inhibitor (eg, Efavirenz 600 mg daily, or nevaripine 200 mg daily for 2 weeks, then 200 mg bid);
•  b) Protease inhibitor (eg, indinavir 800 mg tid, Saquinavir 600 mg tid, or Ritonavir 600 mg bid), Protease inhibitors may cause elevations in serum triglyceride levels. (the duration of treatment is counted from the moment of receiving the results of lab diagnostic tests and or from the moment the patient start to suffer of secondary symptoms- сроки начала лечения уточняются: от момента лабораторной диагностики заболевания, от момента появления вторичных проявлений болезни).

2. Medicament to correct the immune deficit

3. Fighting infectious diseases and invasive tumors

all about AIDS Infection 2015 – Dr Diab

Verified by: Dr.Diab (September 18, 2017)

Citation: Dr.Diab. (September 18, 2017). all about AIDS Infection 2015. Medcoi Journal of Medicine, 4(2). urn:medcoi:article4792.